Nutritional assessment of patients with acute leukemia during induction chemotherapy: association with hospital outcomes

Leuk Lymphoma. 2014 Aug;55(8):1743-50. doi: 10.3109/10428194.2013.853766. Epub 2013 Nov 14.

Abstract

Cancer-related malnutrition causes morbidity and reduced survival. The aim of this study was to evaluate the nutritional and inflammatory status of patients with acute leukemia in association with duration of neutropenic fever (DNF) and length of hospital stay (LHS) during induction chemotherapy. Fifty-five patients with acute lymphoblastic leukemia (ALL) (n = 28) and acute myeloid leukemia (AML) (n = 27) completed the study. There were significant differences between the two groups according to LHS and DNF (p = 0.022 and p = 0.012, respectively): both had a longer period in patients with AML. The patients were statistically different according to body mass index (BMI), pre-albumin, high-sensitivity C-reactive protein (hs-CRP) and patient-generated subjective global assessment (PG-SGA) score (p = 0.049, p = 0.028, p < 0.001, p = 0.030). In patients with ALL, serum albumin and pre-albumin levels were associated with LHS and DNF, respectively. Moreover, PG-SGA score was associated with DNF. In patients with AML, BMI and second pre-albumin level < 10 mg/dL were associated with DNF. Pre-albumin was the common indicator for chemotherapy-related complications in patients with both ALL and AML. Early nutritional assessment can help to find patients with acute leukemia who need nutritional support, and it may contribute to better outcome and less toxicity.

Keywords: Acute myeloid leukemia; acute lymphoblastic leukemia; hospital stay; neutropenic fever; nutritional assessment; pre-albumin.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Antineoplastic Combined Chemotherapy Protocols
  • Body Mass Index
  • C-Reactive Protein / metabolism
  • Cross-Sectional Studies
  • Febrile Neutropenia / etiology
  • Humans
  • Induction Chemotherapy
  • Length of Stay
  • Leukemia, Myeloid, Acute / complications*
  • Leukemia, Myeloid, Acute / drug therapy
  • Male
  • Malnutrition / diagnosis*
  • Malnutrition / etiology*
  • Middle Aged
  • Nutrition Assessment*
  • Outcome Assessment, Health Care
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / complications*
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / drug therapy
  • Serum Albumin
  • Transferrin / metabolism
  • Young Adult

Substances

  • Serum Albumin
  • Transferrin
  • C-Reactive Protein